Provider Demographics
NPI:1528544889
Name:MARCHENA, SAMANTHA KREITMAN
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:KREITMAN
Last Name:MARCHENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 VILLA AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-3820
Mailing Address - Country:US
Mailing Address - Phone:720-335-3892
Mailing Address - Fax:
Practice Address - Street 1:35 VILLA AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-3820
Practice Address - Country:US
Practice Address - Phone:720-335-3892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA126305104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker